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MSN 570 Advanced Pathophysiology Final 2024
1. When does pain in the lower extremities due to peripheral artery disease usually worsen?
- A. with rest because blood flow decreases.
- B. with elevation of the extremity because blood is diverted away.
- C. when the leg is in a dependent position because blood pools.
- D. when the leg is touched or massaged because cytokines are released.
Correct answer: B
Rationale: Pain in the lower extremities due to peripheral artery disease usually worsens with elevation of the extremity because blood is diverted away from the affected area, leading to decreased perfusion and exacerbation of symptoms. Choices A, C, and D are incorrect because resting, dependent position, and touch/massage do not typically worsen the pain associated with peripheral artery disease.
2. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What key contraindication should the nurse review with the patient?
- A. Use of nitrates
- B. History of hypertension
- C. Use of antihypertensive medications
- D. Use of antihypertensive medications
Correct answer: A
Rationale: The correct answer is A: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, so their combined use can lead to a dangerous drop in blood pressure. Choices B, C, and D are incorrect because while a history of hypertension or use of antihypertensive medications may influence treatment decisions, they are not the key contraindication specifically related to sildenafil use.
3. A 50-year-old female was diagnosed with sideroblastic anemia. Which of the following assessment findings would most likely occur?
- A. Bronze-colored skin
- B. Decreased iron
- C. Normochromic erythrocytes
- D. Aplastic bone marrow
Correct answer: A
Rationale: The correct answer is A: 'Bronze-colored skin.' Sideroblastic anemia is characterized by excess iron deposition, leading to bronze-colored skin. This occurs due to the abnormal accumulation of iron in tissues. Choices B, C, and D are incorrect because sideroblastic anemia does not typically present with decreased iron levels, normochromic erythrocytes, or aplastic bone marrow.
4. A patient with a history of venous thromboembolism is prescribed hormone replacement therapy (HRT). What should the nurse emphasize about the risks associated with this therapy?
- A. HRT is associated with an increased risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots.
- B. HRT may improve mood and energy levels, but it also increases the risk of osteoporosis.
- C. HRT can decrease the risk of fractures, but it also increases the risk of developing diabetes.
- D. HRT may increase the risk of breast cancer, so regular mammograms are essential.
Correct answer: A
Rationale: HRT is associated with an increased risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots and advised to seek immediate medical attention if they occur.
5. A 1-year-old child will receive her scheduled MMR vaccination shortly. The nurse should teach the child's parents that she may develop what possible adverse effect related to the administration of this vaccine?
- A. Cough and fever
- B. Pallor and listlessness
- C. Serum sickness
- D. Nausea and vomiting
Correct answer: A
Rationale: The correct answer is A: Cough and fever. After receiving the MMR vaccine, some children may experience mild adverse effects such as a low-grade fever and a mild cough. These symptoms are normal reactions to the vaccine and indicate that the child's immune system is responding appropriately. Choices B, C, and D are incorrect because pallor and listlessness, serum sickness, nausea, and vomiting are not common adverse effects associated with the MMR vaccine in children.
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